Abstract
The recent addition of cyclin-dependent kinase 4 (CDK4) and CDK6 inhibitors to endocrine therapy has remarkably improved the outcome of patients affected with hormone receptor positive (HR+), human epidermal grow factor receptor 2 negative (HER2 -) advanced breast cancer (ABC). Ribociclib showed to be effective across most subgroups, regardless of the number and the site of metastasis. Up to 10% of patients with ABC, reported an oligometastatic condition, recently defined as a slow-volume metastatic disease with limited number and size of metastatic lesions (up to 5 and not necessarily in the same organ), potentially amenable for local treatment, aimed at achieving a complete remission status. Despite the wide use of CDK4/6 inhibitors in HR+, HER2-, ABC treatment, data regarding both locally advanced, inoperable disease and oligometastatic conditions are still poor. We reported a review and case series of HR+, HER2-, ABC patients treated with ribociclib as first-line therapy, for a locally advanced and oligometastatic conditions, reporting an impressive response and good safety profile.
Highlights
The recent addition of cyclin-dependent kinase 4 (CDK4) and CDK6 inhibitors to endocrine therapy has remarkably improved the outcome of patients affected with hormone receptor positive (HR+), human epidermal grow factor receptor 2 negative (HER2 -) advanced breast cancer (ABC) [1]
We reported a case series of HR+, HER2, ABC patients treated with ribociclib as first-line therapy, in two cases for a locally advanced, inoperable disease and the other two cases for oligometastatic conditions, reporting an impressive response and good safety profile
In 2010, she underwent left quadrantectomy surgery plus sentinel lymph node biopsy (SNLB) for a moderately differentiated invasive ductal carcinoma (IDC), non-specific type (NST), with ER 98%, PR 80%, Ki-67 10%, HER-2 negative, immunohistochemistry (IHC) profile. She was subjected to adjuvant treatment with radiotherapy (RT) and hormone therapy (HT) with letrozole 2.5 mg for 5 years
Summary
The recent addition of cyclin-dependent kinase 4 (CDK4) and CDK6 inhibitors to endocrine therapy has remarkably improved the outcome of patients affected with hormone receptor positive (HR+), human epidermal grow factor receptor 2 negative (HER2 -) advanced breast cancer (ABC) [1]. Three third-generation CDK4/6 inhibitors (palbociclib, ribociclib, abemaciclib) have been approved in combination with aromatase inhibitor (AI) or fulvestrant, in both first and subsequent lines of therapy, according to phase III trial results [2,3,4,5,6,7] All three of these CDK4/6 inhibitors demonstrated comparable results in terms of response rate, progression-free survival (PFS), and overall survival (OS), especially if administered in combination with fulvestrant [8,9,10]. We reported a case series of HR+, HER2-, ABC patients treated with ribociclib as first-line therapy, in two cases for a locally advanced, inoperable disease and the other two cases for oligometastatic conditions, reporting an impressive response and good safety profile
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